By Barrett Seaman—
Those who pay attention to the dashboards and daily reports from Governor Cuomo have seen it creeping up. After more than a month of seemingly irreversible declines in the statewide COVID infection rates—to the point where less than half a percent of those tested were coming up positive, the trend reversed, if every so slightly. On the last day of June, 0.43% of those tested statewide proved positive and the seven-day average was 0.40%. Two weeks later, 1.28% of those tested were positive, dragging the seven-day average up to .93%.
There’s no magic number, but epidemiologists have long suggested that an infection rate below one percent means the virus is being choked off; the higher the percentage is above that, the greater the virus’s chances of survival. And the longer it is allowed to survive, the more opportunities it gets to morph into some deadlier and more vaccine-evasive variant. Now there is the Delta variant, an exponentially more contagious virus moving through the country. It has not yet been established that it is in Westchester, but it is a near certainty that it will be.
We all knew why the infection rate was dropping during the spring months: it was the vaccine. As hundreds of thousands of us completed the required dosages and gained protection, the fewer of us were still vulnerable. But then, as summer began, another trend altered: the arc of the vaccination curve that had been rising steeply since Pfizer and Moderna, and to a lesser extent, J&J became available, began to flatten. When he gave his weekly COVID update on Monday, County Executive George Latimer noted that there were only 168 people with vaccine appointments at the County Center that day—at a place where more than 2,000 had been vaccinated daily during March and April. Meanwhile, upstate, the governor was closing down four super vaccination sites. There was—and is—plenty of vaccine to go around, just fewer people willing to take it.
Vaccinations are cumulative, however. “We’re still over 70% and approaching 80%,” said Latimer. Mathematically, the population of unvaccinated people still at risk of catching the virus is shrinking, but at a more stubborn pace. The remaining 20-25% fall into several categories:
Those who won’t trust the three available vaccines until they have gotten full FDA approval. What they need to hear is the overwhelming evidence of the success these vaccines have had to date and the virtual certainty that they will win approval very soon.
Those who don’t trust the government to do right by them. There are several sub-groups here: Blacks have historical reasons (e.g. the Tuskegee syphilis experiments) to question the government’s intentions. Hispanics have had the more recent experience of dealing with ICE deportations. The last sub-group includes arch-conservatives who see big government (read Democrat) coercion behind every effort to persuade them to get the shot.
Those who think they are somehow immune or that the odds of infection are too low for them to be concerned. Young people—teenagers in particular—fall into this category. We all know 18-year-olds are immortal, so why put them through the inconvenience of getting a shot? Some parents, anxious to instill personal responsibility in their children, are reluctant to order them to get vaccinated for the larger good.
Those who think they are more at risk of a bad outcome with the vaccine than they are from getting the virus. This group may include people with autoimmune issues or other health characteristics that may or may not put them at greater risk from the vaccine, but too often, say experts, they are not making the effort to get medical advice as to whether their own condition meets that criterion.
Both health experts and the many volunteers who are out there trying to break through the walls of vaccine resistance agree that the best strategy is to present each holdout with the facts and logic behind getting vaccinated. Those who fear that the drugs are too experimental need to hear the data, says Dr. Sherlita Amler, Westchester County’s Health Commissioner. “It’s been given to hundreds of millions of people,” she observes, and with very few adverse effects and a miniscule number of so-called “breakthrough” cases. “People perceive their risk to be very high when in fact it is very low.”
Yet even as a physician, she acknowledges, “I’m not always successful” in persuading holdouts with the facts.
Public health experts like Dr. Amler had little trouble convincing the over-sixty population to get vaccinated. Well over 80% of them are now protected, largely because they were motivated by fear. “Young people don’t have those issues,” she says. Too often, they feel immortal; early cases suggested their symptoms would be relatively mild; not so now. Another factor with teenagers, she says, is that “self-determination starts to play in their personalities.”
Volunteer groups working to raise the vaccination rates have found some success in putting resisters in direct touch with medical experts who can present them with the facts. One such group, #VaxUp Westchester, recently set up a Zoom session with three practitioners directly answering questions from reluctant women in the Bronx. At least one of them was persuaded to come up to Tarrytown to get her shot.
Persuaders don’t always have to be medical people. Dr. Amler points out that kids in particular are more influenced by sports or entertainment figures—hence the county’s enlistment of New York Knicks players to promote vaccination.
All of this helps explain why the rate of increase for vaccinations is slowing. But it does not explain the more serious rise in the infection rate. That, suggests Dr. Amler, may be as plain as the mask that isn’t on your face.
“What is happening,” she says, “is that a lot of the measures that were put in place to control COVID have been eliminated.” Walk into a supermarket or a department store and see that hardly anyone is wearing a mask or toe-ing the social distancing lines on the floor at checkout. That’s okay for the vaccinated, but many of those who haven’t been vaccinated are taking the same liberties, and it’s not at all obvious which is which.
With the Delta variant right around the corner if not already here, contagion is a greater risk than ever—maybe just for the yet-unvaccinated, but that’s enough to endanger us all. “People are like walking Petri Dishes,” says Dr. Amler. “It only takes one person to end up with a variant.” The more opportunities we give the virus to reinvent itself, the likelier it is that one of them will find a way to beat these otherwise highly effective vaccines.
“We all want to go back to life as usual,” says Dr. Amler. “We may be done with COVID, but COVID is not done with us.”